ABSTRACT
The brain generates complex sequences of movements that can be flexibly configured based on behavioural context or real-time sensory feedback1, but how this occurs is not fully understood. Here we developed a 'sequence licking' task in which mice directed their tongue to a target that moved through a series of locations. Mice could rapidly branch the sequence online based on tactile feedback. Closed-loop optogenetics and electrophysiology revealed that the tongue and jaw regions of the primary somatosensory (S1TJ) and motor (M1TJ) cortices2 encoded and controlled tongue kinematics at the level of individual licks. By contrast, the tongue 'premotor' (anterolateral motor) cortex3-10 encoded latent variables including intended lick angle, sequence identity and progress towards the reward that marked successful sequence execution. Movement-nonspecific sequence branching signals occurred in the anterolateral motor cortex and M1TJ. Our results reveal a set of key cortical areas for flexible and context-informed sequence generation.
Subject(s)
Motor Cortex , Movement , Animals , Mice , Motor Cortex/physiology , Movement/physiology , Optogenetics , Somatosensory Cortex/physiology , Tongue/physiology , TouchABSTRACT
Precise tongue control is necessary for drinking, eating and vocalizing1-3. However, because tongue movements are fast and difficult to resolve, neural control of lingual kinematics remains poorly understood. Here we combine kilohertz-frame-rate imaging and a deep-learning-based neural network to resolve 3D tongue kinematics in mice drinking from a water spout. Successful licks required corrective submovements that-similar to online corrections during primate reaches4-11-occurred after the tongue missed unseen, distant or displaced targets. Photoinhibition of anterolateral motor cortex impaired corrections, which resulted in hypometric licks that missed the spout. Neural activity in anterolateral motor cortex reflected upcoming, ongoing and past corrective submovements, as well as errors in predicted spout contact. Although less than a tenth of a second in duration, a single mouse lick exhibits the hallmarks of online motor control associated with a primate reach, including cortex-dependent corrections after misses.
Subject(s)
Adaptation, Physiological , Attention , Drinking , Motor Cortex/physiology , Psychomotor Performance/physiology , Tongue/physiology , Animals , Biomechanical Phenomena , Deep Learning , Male , Mice , Reaction Time , WaterABSTRACT
The sense of taste is a specialized chemosensory system dedicated to the evaluation of food and drink. Despite the fact that vertebrates and insects have independently evolved distinct anatomic and molecular pathways for taste sensation, there are clear parallels in the organization and coding logic between the two systems. There is now persuasive evidence that tastant quality is mediated by labeled lines, whereby distinct and strictly segregated populations of taste receptor cells encode each of the taste qualities.
Subject(s)
Insecta/physiology , Mammals/physiology , Taste , Animals , Chemoreceptor Cells/physiology , Taste Buds/physiology , Tongue/cytology , Tongue/physiologyABSTRACT
Many bees possess a tongue resembling a brush composed of a central rod (glossa) covered by elongated papillae, which is dipped periodically into nectar to collect this primary source of energy. In vivo measurements show that the amount of nectar collected per lap remains essentially constant for sugar concentrations lower than 50% but drops significantly for a concentration around 70%. To understand this variation of the ingestion rate with the sugar content of nectar, we investigate the dynamics of fluid capture by Bombus terrestris as a model system. During the dipping process, the papillae, which initially adhere to the glossa, unfold when immersed in the nectar. Combining in vivo investigations, macroscopic experiments with flexible rods, and an elastoviscous theoretical model, we show that the capture mechanism is governed by the relaxation dynamics of the bent papillae, driven by their elastic recoil slowed down through viscous dissipation. At low sugar concentrations, the papillae completely open before the tongue retracts out of nectar and thus, fully contribute to the fluid capture. In contrast, at larger concentrations corresponding to the drop of the ingestion rate, the viscous dissipation strongly hinders the papillae opening, reducing considerably the amount of nectar captured. This study shows the crucial role of flexible papillae, whose aspect ratio determines the optimal nectar concentration, to understand quantitatively the capture of nectar by bees and how physics can shed some light on the degree of adaptation of a specific morphological trait.
Subject(s)
Algorithms , Bees/physiology , Feeding Behavior/physiology , Models, Biological , Plant Nectar/chemistry , Tongue/physiology , Animals , Bees/anatomy & histology , Energy Intake/physiology , Pollen/chemistry , Pollination/physiology , Taste Buds/physiology , Tongue/anatomy & histology , ViscosityABSTRACT
While there is increasing acceptance that even young infants detect correspondences between heard and seen speech, the common view is that oral-motor movements related to speech production cannot influence speech perception until infants begin to babble or speak. We investigated the extent of multimodal speech influences on auditory speech perception in prebabbling infants who have limited speech-like oral-motor repertoires. We used event-related potentials (ERPs) to examine how sensorimotor influences to the infant's own articulatory movements impact auditory speech perception in 3-mo-old infants. In experiment 1, there were ERP discriminative responses to phonetic category changes across two phonetic contrasts (bilabial-dental /ba/-/Éa/; dental-retroflex /Éa/-/Éa/) in a mismatch paradigm, indicating that infants auditorily discriminated both contrasts. In experiment 2, inhibiting infants' own tongue-tip movements had a disruptive influence on the early ERP discriminative response to the /Éa/-/Éa/ contrast only. The same articulatory inhibition had contrasting effects on the perception of the /ba/-/Éa/ contrast, which requires different articulators (the lips vs. the tongue) during production, and the /Éa/-/Éa/ contrast, whereby both phones require tongue-tip movement as a place of articulation. This articulatory distinction between the two contrasts plausibly accounts for the distinct influence of tongue-tip suppression on the neural responses to phonetic category change perception in definitively prebabbling, 3-mo-old, infants. The results showing a specificity in the relation between oral-motor inhibition and phonetic speech discrimination suggest a surprisingly early mapping between auditory and motor speech representation already in prebabbling infants.
Subject(s)
Evoked Potentials/physiology , Hearing/physiology , Pattern Recognition, Visual/physiology , Speech Perception/physiology , Speech/physiology , Acoustic Stimulation/methods , Electroencephalography , Female , Humans , Infant , Language Development , Male , Phonetics , Tongue/anatomy & histology , Tongue/physiologyABSTRACT
Tongue function is vital for chewing and swallowing and lingual dysfunction is often associated with dysphagia. Better treatment of dysphagia depends on a better understanding of hyolingual morphology, biomechanics, and neural control in humans and animal models. Recent research has revealed significant variation among animal models in morphology of the hyoid chain and suprahyoid muscles which may be associated with variation in swallowing mechanisms. The recent deployment of XROMM (X-ray Reconstruction of Moving Morphology) to quantify 3D hyolingual kinematics has revealed new details on flexion and roll of the tongue during chewing in animal models, movements similar to those used by humans. XROMM-based studies of swallowing in macaques have falsified traditional hypotheses of mechanisms of tongue base retraction during swallowing, and literature review suggests that other animal models may employ a diversity of mechanisms of tongue base retraction. There is variation among animal models in distribution of hyolingual proprioceptors but how that might be related to lingual mechanics is unknown. In macaque monkeys, tongue kinematics-shape and movement-are strongly encoded in neural activity in orofacial primary motor cortex, giving optimism for development of brain-machine interfaces for assisting recovery of lingual function after stroke. However, more research on hyolingual biomechanics and control is needed for technologies interfacing the nervous system with the hyolingual apparatus to become a reality.
Subject(s)
Deglutition Disorders , Deglutition , Animals , Humans , Deglutition/physiology , Mastication/physiology , Tongue/physiology , Hyoid Bone , Biomechanical PhenomenaABSTRACT
There have been many reports of normative pharyngeal swallowing pressures using high-resolution pharyngeal manometry, but there is a fair amount of between-subject variance in reported pressure parameters. The purpose of this study was to put forward normative pharyngeal high-resolution manometry measures across the lifespan and investigate the effects of age, size of system, and sex. High-resolution pharyngeal manometry was performed on 98 healthy adults (43 males) between the ages 21 and 89. Pressure duration, maxima, integral, and within-individual variability metrics were averaged over 10 swallows of 10-ml thin liquid. Multiple linear and logistic regressions with model fitting were used to examine how pharyngeal pressures relate to age, pharyngeal size, and sex. Age was associated with tongue base maximum pressure, tongue base maximum variability, and upper esophageal sphincter-integrated relaxation pressure (F3,92 = 6.69; p < 0.001; adjusted R2 = 0.15). Pharyngeal area during bolus hold was associated with velopharynx integral (F1,89 = 5.362; p = 0.02; adjusted R2 = 0.05), and there was no significant model relating pharyngeal pressures to C2-C4 length (p < 0.05). Sex differences were best described by tongue base integral and hypopharynx maximum variability (χ2 = 10.27; p = 0.006; pseudo R2 = 0.14). Normative data reveal the distribution of swallow pressure metrics which need to be accounted for when addressing dysphagia patients, the importance of pressure interactions in normal swallow, and address the relative stability of swallow metrics with normal aging.
Subject(s)
Deglutition , Manometry , Pharynx , Pressure , Humans , Manometry/methods , Male , Female , Middle Aged , Aged , Adult , Pharynx/physiology , Aged, 80 and over , Deglutition/physiology , Young Adult , Age Factors , Sex Factors , Reference Values , Esophageal Sphincter, Upper/physiology , Healthy Volunteers , Tongue/physiologyABSTRACT
Modern humans and chimpanzees share a common ancestor on the phylogenetic tree, yet chimpanzees do not spontaneously produce speech or speech sounds. The lab exercise presented in this paper was developed for undergraduate students in a course entitled "What's Special About Human Speech?" The exercise is based on acoustic analyses of the words "cup" and "papa" as spoken by Viki, a home-raised, speech-trained chimpanzee, as well as the words spoken by a human. The analyses allow students to relate differences in articulation and vocal abilities between Viki and humans to the known anatomical differences in their vocal systems. Anatomical and articulation differences between humans and Viki include (1) potential tongue movements, (2) presence or absence of laryngeal air sacs, (3) presence or absence of vocal membranes, and (4) exhalation vs inhalation during production.
Subject(s)
Pan troglodytes , Speech Acoustics , Speech , Humans , Animals , Pan troglodytes/physiology , Speech/physiology , Tongue/physiology , Tongue/anatomy & histology , Vocalization, Animal/physiology , Species Specificity , Speech Production Measurement , Larynx/physiology , Larynx/anatomy & histology , PhoneticsABSTRACT
BACKGROUND: Oral frailty, characterised by reduced oral function, is associated with systemic health issues in older adults. Although the criteria for diminished oral function often focus on motor and secretory abilities, texture perception also plays a crucial role in health due to its impact on food intake and palatability. OBJECTIVE: This study aimed to explore the relationship between thickness discrimination ability (TDA) and oral motor and secretory functions in healthy young individuals. METHODS: Twenty-eight adults were assessed for texture perception using eight concentrations of aqueous xanthan gum solutions to determine TDA scores. Measurements of occlusal force, masticatory performance, tongue pressure, stimulated salivary flow rate and tongue-lip motor function were conducted. Spearman's correlation analysis was used to evaluate the relationship between TDA scores and oral functions. Participants were divided into high-sensitivity and low-sensitivity groups based on their TDA scores to compare oral function test results. RESULTS: The TDA scores varied among the participants, with higher scores correlating with higher masticatory performance (r = 0.41, p < .05). Masticatory performance in the high-sensitivity group was significantly higher than in the low-sensitivity group (211.9 ± 59.2 mg/dL vs. 157.9 ± 43.0 mg/dL, p = .013), with no significant differences in other oral functions. CONCLUSION: Masticatory performance was correlated with TDA, suggesting a link between the selection function of mastication and thickness discrimination. These findings highlight the potential relevance of texture perception in oral function and indicate the need for further exploration, particularly in older adults with declining oral health.
Subject(s)
Mastication , Tongue , Humans , Female , Male , Mastication/physiology , Adult , Young Adult , Tongue/physiology , Healthy Volunteers , Saliva/chemistry , Bite Force , Lip/physiology , Polysaccharides, BacterialABSTRACT
BACKGROUND: High-density surface electromyography (HD-sEMG) has enabled non-invasive analysis of motor unit (MU) activity and recruitment, but its application to swallowing-related muscles is limited. OBJECTIVE: We aimed to investigate the utility of HD-sEMG for quantitatively evaluating the MU recruitment characteristics of the suprahyoid muscles during tongue elevation. METHODS: We measured the sEMG activity of the suprahyoid muscles of healthy participants during tongue elevation using HD-sEMG. Maximum voluntary contraction (MVC) was measured, followed by data collection during sustained and ramp-up tasks to capture suprahyoid muscle activity. Changes in the temporal/spatial MU recruitment patterns within individual suprahyoid muscles were analysed. RESULTS: This study enrolled 16 healthy young adults (mean age: 27.8 ± 5.3 years; eight males and eight females). Increasing muscle force corresponded to a decrease in modified entropy and correlation coefficient and an increase in the coefficient of variation. No significant differences were observed between male and female participants. CONCLUSION: The results of this study, consistent with those observed in other muscles, such as the vastus lateralis muscle, suggest that HD-sEMG is a valuable and reliable tool for quantitatively evaluating MU recruitment in the suprahyoid muscles. This measurement technique holds promise for novel assessments of swallowing function.
Subject(s)
Deglutition , Electromyography , Muscle Contraction , Tongue , Humans , Electromyography/methods , Male , Female , Deglutition/physiology , Tongue/physiology , Adult , Muscle Contraction/physiology , Healthy Volunteers , Young Adult , Recruitment, Neurophysiological/physiologyABSTRACT
BACKGROUND: Jaw clenching improves dynamic reactive balance on an oscillating platform during forward acceleration and is associated with decreased mean sway speed of different body regions. OBJECTIVE: It is suggested that jaw clenching as a concurrent muscle activity facilitates human motor excitability, increasing the neural drive to distal muscles. The underlying mechanism behind this phenomenon was studied based on leg and trunk muscle activity (iEMG) and co-contraction ratio (CCR). METHODS: Forty-eight physically active and healthy adults were assigned to three groups, performing three oral motor tasks (jaw clenching, tongue pressing against the palate or habitual lower jaw position) during a dynamic one-legged stance reactive balance task on an oscillating platform. The iEMG and CCR of posture-relevant muscles and muscle pairs were analysed during platform forward acceleration. RESULTS: Tongue pressing caused an adjustment of co-contraction patterns of distal muscle groups based on changes in biomechanical coupling between the head and trunk during static balancing at the beginning of the experiment. Neither iEMG nor CCR measurement helped detect a general neuromuscular effect of jaw clenching on the dynamic reactive balance. CONCLUSION: The findings might indicate the existence of robust fixed patterns of rapid postural responses during the important initial phases of balance recovery.
Subject(s)
Electromyography , Jaw , Muscle Contraction , Postural Balance , Tongue , Humans , Postural Balance/physiology , Male , Female , Adult , Jaw/physiology , Tongue/physiology , Muscle Contraction/physiology , Muscle, Skeletal/physiology , Young Adult , Biomechanical Phenomena/physiology , Healthy Volunteers , Posture/physiologyABSTRACT
OBJECTIVE: To evaluate the agreement between measurements of invasive blood pressure (IBP) and oscillometric blood pressure from the tongue (OBPton) using a multiparameter monitor. STUDY DESIGN: Unblinded, prospective, experimental study. ANIMALS: A total of 12 female Large White crossbreed pigs. METHODS: Pigs undergoing experimental procedures that required arterial cannula placement were recruited. A blood pressure cuff with the closest width to 40% of the circumference of the tongue was placed rostral to the lingual frenulum. Systolic, mean and diastolic IBP and OBPton were measured simultaneously at 5 minute intervals. Agreement between paired measurements was examined using Bland-Altman analysis. Mean bias, precision (standard deviation of mean bias), 95% limits of agreement, correlation coefficients and percentage of measurements within 10 and 20 mmHg of IBP were calculated. RESULTS: The total numbers of paired measurements recorded were 124, 126 and 124 for systolic, mean and diastolic blood pressures, respectively. The mean bias, precision and 95% limits of agreement for systolic OBPton were 11.5, 11.5 (-11.1 to 34.2), for mean OBPton 5.6, 5.7 (-5.7 to 16.8) and for diastolic OBPton 7.6, 10.1 (-12.1 to 27.4) mmHg. Correlation coefficients were greater than 0.9 for mean OBPton only. More than 50% of measurements were within 10 mmHg of IBP and 80% of measurements were within 20 mmHg of IBP for mean and diastolic OBPton only. CONCLUSIONS AND CLINICAL RELEVANCE: The tongue as a cuff site for oscillometric blood pressure measurement is a useful site for measuring mean arterial, but not systolic or diastolic blood pressure in anaesthetized Large White crossbreed pigs. This technique fulfils the American College of Veterinary Internal Medicine criteria for measuring mean arterial pressure but not systolic or diastolic arterial pressure.
Subject(s)
Blood Pressure Determination , Blood Pressure , Oscillometry , Tongue , Animals , Female , Blood Pressure Determination/veterinary , Blood Pressure Determination/methods , Swine/physiology , Oscillometry/veterinary , Oscillometry/methods , Tongue/physiology , Blood Pressure/physiology , Prospective StudiesABSTRACT
Electrogustometry (EGM) is a practical way to test taste. It is typically performed using unipolar electrodes, with the anode on the tongue and the cathode on the hand, forearm, or neck. This results in electric current passing through nontaste tissues and adds a level of impracticality to its clinical application. We compared, using a repeated measures counterbalanced design, anodal thresholds from a unipolar electrode to those of a unique bipolar electrode in which the anode and cathode are contiguously located. Both sides of the anterior tongue were assessed in 70 subjects, as were the effects of age and sex. Nonparametric analyses were performed. The median threshold of the bipolar electrode's central disk (2.49 µA) did not differ from that of the unipolar electrode (2.96 µA) (P = 0.84). On average, older persons exhibited higher thresholds. No significant sex or tongue side effects were evident. Interestingly, when the annular (donut-shaped) bipolar electrode served as the anode, the threshold was higher than that of the other electrodes (5.19 µA; Ps < 0.001). This conceivably reflected lessened summation of activity among adjacent afferents and partial sampling of tongue regions with fewer taste buds. Correlations among all EGM thresholds were nominally higher for women than for men, ranging from 0.83 to 0.85 for women and 0.54 to 0.67 for men; all Ps < 0.001. This study validates the use of a bipolar electrode for assessing taste function, averting movement of current through nontaste-related tissues and making such testing safer and more practical.
Subject(s)
Taste Buds , Taste Threshold , Male , Humans , Female , Aged , Aged, 80 and over , Taste Threshold/physiology , Taste Buds/physiology , Tongue/physiology , Taste/physiology , Electrodes , Electric Stimulation/methodsABSTRACT
Auditory speech perception enables listeners to access phonological categories from speech sounds. During speech production and speech motor learning, speakers' experience matched auditory and somatosensory input. Accordingly, access to phonetic units might also be provided by somatosensory information. The present study assessed whether humans can identify vowels using somatosensory feedback, without auditory feedback. A tongue-positioning task was used in which participants were required to achieve different tongue postures within the /e, ε, a/ articulatory range, in a procedure that was totally nonspeech like, involving distorted visual feedback of tongue shape. Tongue postures were measured using electromagnetic articulography. At the end of each tongue-positioning trial, subjects were required to whisper the corresponding vocal tract configuration with masked auditory feedback and to identify the vowel associated with the reached tongue posture. Masked auditory feedback ensured that vowel categorization was based on somatosensory feedback rather than auditory feedback. A separate group of subjects was required to auditorily classify the whispered sounds. In addition, we modeled the link between vowel categories and tongue postures in normal speech production with a Bayesian classifier based on the tongue postures recorded from the same speakers for several repetitions of the /e, ε, a/ vowels during a separate speech production task. Overall, our results indicate that vowel categorization is possible with somatosensory feedback alone, with an accuracy that is similar to the accuracy of the auditory perception of whispered sounds, and in congruence with normal speech articulation, as accounted for by the Bayesian classifier.
Subject(s)
Feedback, Physiological , Phonetics , Sensation/physiology , Speech Perception/physiology , Tongue/physiology , Adult , Female , Humans , Male , Palate/physiology , Speech Production Measurement , Young AdultABSTRACT
The evolution of ballistic tongue projection in plethodontid salamanders-a high-performance and thermally robust musculoskeletal system-is ideal for examining how the components required for extreme performance in animal movement are assembled in evolution. Our comparative data on whole-organism performance measured across a range of temperatures and the musculoskeletal morphology of the tongue apparatus were examined in a phylogenetic framework and combined with data on muscle contractile physiology and neural control. Our analysis reveals that relatively minor evolutionary changes in morphology and neural control have transformed a muscle-powered system with modest performance and high thermal sensitivity into a spring-powered system with extreme performance and functional robustness in the face of evolutionarily conserved muscle contractile physiology. Furthermore, these changes have occurred in parallel in both major clades of this largest family of salamanders. We also find that high-performance tongue projection that exceeds available muscle power and thermal robustness of performance coevolve, both being emergent properties of the same elastic-recoil mechanism. Among the taxa examined, we find muscle-powered and fully fledged elastic systems with enormous performance differences, but no intermediate forms, suggesting that incipient elastic mechanisms do not persist in evolutionary time. A growing body of data from other elastic systems suggests that similar coevolution of traits may be found in other ectothermic animals with high performance, particularly those for which thermoregulation is challenging or ecologically costly.
Subject(s)
Muscle Contraction/physiology , Tongue/physiology , Urodela/physiology , Adaptation, Biological/genetics , Animals , Biological Evolution , Biomechanical Phenomena , Body Temperature Regulation , Feeding Behavior/physiology , Movement , Muscles/physiology , Musculoskeletal Development , Phylogeny , Predatory Behavior/physiology , Temperature , Tongue/metabolism , Urodela/anatomy & histologyABSTRACT
BACKGROUND: Alterations in oral health have a negative impact on the quality of life of persons with intellectual disabilities (PwIDs). Chewing is a process that influences and determines optimal oral health. However, little is known about how intellectual disability (ID) affects masticatory performance. This study aimed to analyse the differences in masticatory performance between young adults with IDs, young adults without IDs and older adults without IDs. METHODS: A cross-sectional analytical design was used. The masticatory performance was evaluated with a chewing gum validated instrument. In addition, the labial and tongue strength was assessed with the Iowa Oral Performance Instrument. We compared the masticatory performance between groups using one-way analysis of covariance. Body mass index, muscle mass, missing teeth, lip strength and tongue strength were included as separate covariates. A multivariate regression analysis was performed to identify which independent variables could explain masticatory performance in each group. RESULTS: Thirty-two PwIDs, 31 young adults without IDs and 32 older adults without IDs were recruited. PwIDs showed poorer masticatory performance compared with older adults (mean difference: -3.06, 95% confidence interval: -3.87 to -2.26) and healthy controls (mean difference: -2.38, 95% confidence interval: -3.19 to -1.57). The analysis of covariance showed significant difference between groups in the masticatory performance (F = 47.35, P < 0.001, ηp 2 = 0.507). Missing teeth (P < 0.001), right lip strength (P = 0.025) and tongue strength (P = 0.007) as covariables showed a significant interaction with the model. In the PwID group, lip strength and lack of teeth explained 58% of the variance in masticatory performance (R2 = 0.580, standard error = 1.12, P < 0.001). CONCLUSIONS: Persons with intellectual disabilities have a poorer masticatory performance than adults without IDs. Our findings indicate that the primary determinants of optimal masticatory function in PwIDs are the strength of the lip seal and the number of missing teeth.
Subject(s)
Intellectual Disability , Humans , Young Adult , Aged , Cross-Sectional Studies , Lip , Quality of Life , Tongue/physiologyABSTRACT
Muscle fatigue is the diminution of force required for a particular action over time. Fatigue may be particularly pronounced in aging muscles, including those used for swallowing actions. Because risk for swallowing impairment (dysphagia) increases with aging, the contribution of muscle fatigue to age-related dysphagia is an emerging area of interest. The use of animal models, such as mice and rats (murine models) allows experimental paradigms for studying the relationship between muscle fatigue and swallowing function with a high degree of biological precision that is not possible in human studies. The goal of this article is to review basic experimental approaches to the study of murine tongue muscle fatigue related to dysphagia. Traditionally, murine muscle fatigue has been studied in limb muscles through direct muscle stimulation and behavioral exercise paradigms. As such, physiological and bioenergetic markers of muscle fatigue that have been validated in limb muscles may be applicable in studies of cranial muscle fatigue with appropriate modifications to account for differences in muscle architecture, innervation ratio, and skeletal support. Murine exercise paradigms may be used to elicit acute fatigue in tongue muscles, thereby enabling study of putative muscular adaptations. Using these approaches, hypotheses can be developed and tested in mice and rats to allow for future focused studies in human subjects geared toward developing and optimizing treatments for age-related dysphagia.
Subject(s)
Deglutition Disorders , Muscle Fatigue , Humans , Rats , Mice , Animals , Deglutition Disorders/etiology , Muscle, Skeletal/physiology , Tongue/physiology , Deglutition/physiologyABSTRACT
Patients with oral cancer have poor nutritional status before treatment. However, there have been no reports of the detailed evaluation of preoperative oral function in patients with oral squamous cell carcinoma (OSCC). Therefore, this study aimed to evaluate the preoperative oral function of patients with OSCC and examine the relationship with nutritional status. Oral function measurements (microorganisms, oral dryness, occlusal force, tongue pressure, masticatory function, Eating Assessment Tool, and Postoperative Oral Dysfunction Scale) and Mini Nutritional Assessment-Short Form (MNA-SF) data were collected from 51 patients with OSCC (men: 37, women: 14, mean age: 72.1 years) who visited the Shimane University Hospital, Department of Oral and Maxillofacial Surgery, from September 2019 to September 2021. The tongue was the most prevalent primary gingiva site [22 patients (43.1%)], and 36 patients (70.6%) had advanced cancer. Comparisons between nutritional status and each related factor revealed significant differences in the number of individuals in the household, cancer stage, presence of pulmonary disease, number of teeth, microorganisms (grade), and masticatory function (mg/dL) (p < 0.05). Multiple regression analysis using the total MNA-SF score as the dependent variable with adjustment for confounding factors showed significant association between oral dryness and tongue pressure (p < 0.05). No significant association was found for the Eating Assessment Tool or Postoperative Oral Dysfunction scale. Patients with OSCC may have decreased oral function because of the tumor at the time of diagnosis, which causes a decline in nutritional status. Preoperative interventions are necessary to improve nutrition based on the state of oral function.
Subject(s)
Carcinoma, Squamous Cell , Malnutrition , Mouth Neoplasms , Male , Humans , Female , Aged , Cross-Sectional Studies , Tongue/physiology , Mouth Neoplasms/complications , Mouth Neoplasms/surgery , Pressure , Nutritional Status , Nutrition AssessmentABSTRACT
INTRODUCTION: In the last decade, compartmental surgery (CTS) has been the surgical approach of choice for advanced tumors of the tongue and oral floor. METHODS: Advanced tumors (cT3-T4) oral tongue squamous cell carcinoma (OTSCC) may extend beyond the lingual septum and involve the contralateral hemitongue, developing along the intrinsic transverse muscle. The disease may then involve the genioglossus muscle and, more laterally, the hyoglossus muscle. RESULTS: The surgical approach to the contralateral tongue must be guided by anatomic and anatomopathological principles to achieve a safe oncological resection based on the principles of CTS. CONCLUSION: We propose a schematic classification of glossectomies that extend to the contralateral hemitongue based on the anatomy and pathways of tumor spread.
Subject(s)
Carcinoma, Squamous Cell , Head and Neck Neoplasms , Tongue Neoplasms , Humans , Glossectomy , Tongue Neoplasms/surgery , Tongue Neoplasms/pathology , Squamous Cell Carcinoma of Head and Neck/surgery , Carcinoma, Squamous Cell/surgery , Carcinoma, Squamous Cell/pathology , Tongue/physiology , Head and Neck Neoplasms/surgeryABSTRACT
The objective of this study was to determine the tongue-palatal contact changes in patients with skeletal maxillary protrusion after sagittal split ramus osteotomy (SSRO) during swallowing. In this study, 15 patients with maxillary protrusion and 10 normal subjects participated. Before and 3 months after surgery, tongue-palatal contact patterns during swallowing of patients with maxillary protrusion as well as controls were evaluated by electropalatography. The electrode contact number in the alveolar, palatal, and velar parts was examined. The swallowing duration of each phase was also evaluated. In the lateral area of the velar part, incomplete electrode contact was shown at 0.3 seconds in patients with maxillary protrusion. The electrode contact number in the velar part at 0.3 seconds before tongue-palatal complete contact was significantly less in the preoperative patients compared with the controls ( P < 0.05). A small increase in the electrode contact number of the velar part was shown in the postoperative patients at 0.3 and 0.2 seconds before tongue-palatal complete contact ( P < 0.05). The pharyngeal phase duration was significantly larger in the patients with maxillary protrusion before SSRO compared with the controls ( P < 0.05). After SSRO, the pharyngeal phase duration was significantly shortened. It was shown that the tongue-palatal contact pattern during swallowing in patients with maxillary protrusion improved after orthognathic surgery, and the pharyngeal phase duration was also shortened. It is suggested that the changes in the mesiodistal mandibular position by orthognathic surgery can improve tongue posture and movement during swallowing.